Regular dentist visits

Kicking off at the age of 1 at the latest, or within 6 months of the first tooth appearing, your child should see their dentist regularly and understand that visiting them is an important part of growing up. If you receive benefits such as Family Tax Benefit A payments, you can take advantage of government programs such as the Child Dental Benefits Schedule.

Early Childhood Caries (Decay)

An infant or young child may be assessed by the dentist to have tooth decay, dental fillings or missing teeth.

The main risk factors for childhood decay are:

• settling the baby or young child with a bottle of milk, sweet flavoured milk, cordial, soft drink or fruit juice. Bacteria feed on the sugar in these drinks and form a sticky coating of plaque. Plaque acids eat into tooth enamel and cause decay.
• Bottle feeding beyond 12 months
• a high sugar diet with frequent snacking or ‘grazing’
• certain oral health problems, such as dry mouth (lack or saliva) and mouth breathing
• lack of good brushing and flossing
• sleep-behaviour problems

Regular dental check-ups are important for all children, especially if your child has the risk factors for earlt childhood decay. Without treatment, your child may develop toothache, infection and dental abscess, and lose teeth too early. Missing teeth in a young child can result in serious orthodontic problems of the permanent teeth, requiring extensive and costly treatment.

Tips to prevent Early Childhood Decay

• daily brushing with a low fluoride toothpaste and flossing
• a balanced diet and good nutrition
• regular visits to the dentist
• If your baby has teeth, it’s best to avoid settling them to sleep overnight with a
  breastfeed or bottle of milk, sweetened flavoured milk, cordial, soft drink or fruit
  juice. Bacteria feed onthe sugar in these drinks and form plaque acids on teeth, which eat into the tooth surface and cause decay.
• Encourage your baby to learn to drink from a toddler cup from 12 months of age.
• Don’t allow your child to take a bottle of milk or other sugary drinks to bed.
• If your baby needs to suck on something to settle them to sleep, offer a dummy rather than a bottle.
• If your baby has a breastfeed or bottle of milk before bed, gently wipe down their teeth with a moistened cloth before putting them to sleep.
• Avoid giving your baby or toddler frequent snacks – three meals and two snacks
  per day is ideal to meet dietary needs.

Brushing and Flossing tips

Start brushing the teeth as soon as they erupt. Use a children’s toothbrush with a small head and soft, rounded bristles. Preferably, a child’s teeth should be brushed twice a day, morning and evening.

When your child is about two and a half years old, flossing should be done daily. At the least, floss twice a week.

If flossing is difficult in your child, ask your dentist to show you how to do it.

Floss holders can be bought that make flossing easier for some children.

Children younger than about eight to ten years cannot properly clean their own teeth, and parents have to supervise.

Choose a position where you can easily see your child’s mouth.

For example, sit your child on your lap or stand behind your child with the head tilted back slightly. Or lay the child down on your lap as you sit on a couch or bed.

Plaque-disclosing tablets (available from your dentist or pharmacist) contain food dye that turns plaque pink or red.

These tablets can help you and your child to see if the brushing technique removes plaque from every tooth surface.

Flossing

Slide the floss between the teeth, and gently work it up and down, against the surface of each tooth. Do not snap the floss down between the teeth as it may cut into the floss down between the teeth as it may cut into the gum and cause bleeding. After flossing, rinse with water, then brush (or brush then floss).

Good Brushing Technique

Move the brush gently in small circles to clean the front surface of your child’s teeth. To reach inner surfaces, tilt the toothbrush. Avoid side-to-side scrubbing, which can damage teeth and gums. Brush for about two minutes, if your child will tolerate it.

Brushing the back teeth

Brush the biting and grinding surfaces of back teeth with a gentle back and forth motion. Clean every surface of every tooth. Brush around the gum line of each tooth. Your dentist may have further advice on use of the toothbrush.

Toddler taming

If your toddler resist brushing or cannot sit still for two minutes, then try these suggestions:

• Sing nursery thymes or play a favourite song on the CD player as you brush.
• Distract your child with a toy or TV program
• Consider a battery-powered brush
• Offer a reward. For example, you could put a sticker on a “star chart” each time your child allows you to brush for two minutes. Give your child a reward once the star chart is full of stickers, such as going somewhere special.

Encourage your preschooler to practise teeth cleaning (under your supervision) to instill good oral hygiene habits from an early age. Use a combination of “show and tell” methods. For example, you could brush your teeth as your child imitates you; then next time. Tell your child how to brush while you watch. Your child may prefer one method to the other.

For toddlers who are reluctant to brush, encourage them to brush at the end of their bath time when it is “their turn”. When you wrap the child in a towel after the bath, you can quickly check that the brushing was done properly.

Make flossing and brushing as much fun as you can because arguments and tears will add to your child’s resistance. Talk to your dentist if you need advice.

Introduce low-fluoride toothpaste when your child is about 18 months old. Replace toothbrushes every three months or when bristles appear frayed. Frayed bristle do not effectively remove plaque and may scratch the gums.

Good nutrition is important for oral and dental health

• Offer a diet high in fresh fruits and vegetables, wholegrain cereals, lean meats and dairy products
• Limit sugary snacks such as lollies, fruit bards, muesli bars, biscuits, dried fruit, cordials, juices and soft drinks
• A healthy diet does not make brushing and flossing unnecessary. Many healthy foods (such as fruit) contain high amounts of sugar. Starchy foods (such as bread, pasta and crackers) and milk products (including breast milk) can cause the growth of dental plaque. Daily flossing and brushing greatly reduce the risk of tooth decay.
• Xylitol is a natural sweetener from the white birch tree. Foods containing sugar substitutes appear to reduce decay causing bacteria. Ask your dentist if xylitol products (such as gum, syrup or lozenges) would be useful in reducing your family’s risk of tooth decay.
• If your child needs medicines, as your doctor if they can be sugar free; alternative sweeteners can be used.

Fluoride strengthens teeth

Fluoride strengthens tooth enamel and protects against decay. Most capital cities in Australia add fluoride to the water supply at recommenced levels. Your dentist can tell you if your local water supply is fluoridated.

Not all water sources contain fluoride. Bottled water typically does not contain enough fluoride to offer protection against tooth decay. Some home water filters remove fluoride from tap water. Storage-tank water does not contain fluoride. Consult your dentist. If needed, the dentist may apply a fluoride “varnish” twice yearly, which has been proven to reduce childhood tooth decay.

To much fluoride during tooth development can cause mild white flecking or mottling or permanent teeth (enamel fluorosis). A young child who regularly swallows adult-strength fluoride toothpaste instead of spitting it out may develop enamel fluorosis.

To prevent it:

• choose a low-fluoride toothpaste for children younger than 6
• apply a pea-sized amount to the toothbrush and smear it into the bristles
• encourage your child to spit out the toothpaste after brushing
• store all toothpaste of out of your child’s reach. Some small children love the taste of toothpaste and will eat it if given the chance